General Hospital, London,
January 1899.

I don't think I have written to you since I slipped back into my work here.

We got back from Egypt in April, and I spent a little time at home and paid a few visits, and then the Matron asked me if I would return to take charge of one of the women's surgical wards for four months while the sister was away on sick leave; so back I came at the beginning of July, and it seems as though I am likely to remain. I had such a nice welcome back from every one (from the surgeons down to the porters), that I soon felt quite at home again.

At first it was rather strange, as they have changed the "off duty" times, and all the nurses get more time off, so that means you have more nurses, and when they were all on together it seemed such a crowd to me: in that ward for twenty-two beds and four cots I had a staff nurse, a senior probationer, and three other probationers, and two lady pupils, seven besides myself on day duty and a staff nurse and a probationer on night duty; but it is seldom they are all on at the same time, and I have to run around and see that those who are on attend to the work of those who are off, and that things are not neglected because "it is not my work"!

It is nice for the nurses not to be so rushed as we used to be, but I am not quite sure that it is such good training; I don't think they feel quite so personally responsible for their patients' welfare as they did when there was no one equally responsible with them; it is rather difficult to explain exactly what I mean—for one thing, the staff nurses now have two days off together each month, so we have a senior probationer who takes over their work for those two days, and I find they get much more out of touch with what has been ordered for the patients than they did when they were away only for one day; but I am getting used to it now.

The ward I had when I first came back was rather dingy, and I regretted all the nice flower-pots and vases I had left behind in the ward I had when I was last here, to say nothing of my nice stock of children's clothes (I had heaps of white sailor blouse tops for the small boys, and muslin pinafores for the little girls, with pale blue frocks to wear under the pinafores on high days and holidays); but I did not spend much on vanities in that ward, as it was not worth while for a short time, and the more fancy things you have the more it costs you in washing, as the hospital won't pay for vanities, though it does make a difference to the look of your ward when visitors go round, and the mothers just love to see their poor little kiddies dressed up "like a real little lady" instead of in flannelette!

I liked both the night and the day staff nurse in that ward, and they were very nice to me (sometimes staff nurses are not nice to a sister doing temporary work, as they often think they might have been allowed to do the sister's work themselves).

The ward had been noted for never being without squalling babies, and I was rather amused to hear from another old nurse of mine that these staff nurses had learnt that I was very particular about tidiness, and very anxious that the babies should have no reasonable excuse for squalling; so they were determined to try to please me in those respects. One day I came down from the theatre (after being up for several operations) just at tea-time, and I thought the ward looked rather untidy, but I wanted my tea so badly and the ward-maid had it all ready for me, so, after taking a look at the operation cases, I—rather unwisely—concluded I would drink it before going round to tidy up, and, of course, before I had finished tea the Matron came in, and I had to escort her round, inwardly fuming at some crumbs by a child's cot, and some of the trays brought down from the theatre and not put tidily away; but Matron was very amiable, and when we got to the door she said, "Sister, I never remember seeing the ward so trim and neat after a theatre afternoon, and not a single baby squalling!"—so of course I told the staff nurse, and she was mightily pleased.

We had had a curious case in the theatre that afternoon—a poor little scrap of a baby, one day old, born with an imperforate anus; as soon as they began to give it an anÆsthetic it stopped breathing, and after trying to revive it for some time the surgeon put on his coat and went away, but we continued doing artificial respiration, and eventually the child came round; so another surgeon (who was still in the hospital) came in, and he advised the house surgeon to do colostomy, which he did very rapidly, and the poor little mite was relieved, but it only lived a day.

We had a first-rate house surgeon on just then, and he looked after his dressers well. You have no idea how slack and lazy the dressers sometimes get if the house surgeon is not keen, and it makes a vast difference to the patients' comfort.

It happened to be our "take in" week when Bank Holiday came, and we had a very lively week. Altogether we took in sixteen cases, but a few of them were injuries to arms or fingers, so they were able to go out again after a night or two, thus leaving beds free for others.

On Bank Holiday itself things were pretty quiet until the evening, and then we had four accidents in two hours—an old lady of seventy-nine with a fractured femur, a baby with a scalp wound (fell from its chair on to the fender), a little child badly scalded, and a very big and fat woman with a fractured tibia and fibula, who, I was horrified to find, was expecting a baby to arrive very shortly, and as none of my nurses had had any experience of such things, nor had the present night sister, I felt obliged to keep within hail both night and day; but one Sunday I thought it seemed safe to go out to church, and another sister promised to attend if required, and sure enough she was required, but all went well, and the mother made a good recovery, and I think was rather pleased to go out with a fine healthy baby, having been saved all the expense of her confinement.

When the sister of that ward returned, there was a small men's accident ward vacant, so I was offered that until a larger ward should be free.

I was sorry to leave the children, but the new ward was under the surgeons for whom I had worked before I went to Egypt, and I was glad to be on for them again.

It was November when I moved my camp, and I seemed to have hardly had time to turn round before Christmas was upon us, and a very bright and cheery Christmas we had, in spite of the fact that we were "taking in," and the cases simply streamed in. Altogether we admitted twenty-one cases during the week for our twenty beds. Of course some kept going out, but we had to send our most movable patients to sleep in other wards, so as to keep a bed always ready for the next accident.

Amongst the cases we had two poor fellows who had cut their throats; one a lad of twenty-one who had had influenza, and the other a man of thirty-two who had been jilted by a girl. They both had tracheotomy done, and both did pretty well at first, but I don't think the younger man wanted to get better, and eventually he got pneumonia and died. The other man got all right again. All through Christmas week they both had policemen sitting by them in case they should attempt suicide again, and these policemen were most useful in helping with the decorations.

At the same time we had a big drayman in, who had fallen off his dray and got slight concussion of the brain. He did not get quite sensible for some time (though he was never very ill), and he was always trying to get out of bed, and whenever any one got up on the ladders to do a little decorating there would be a call that "No. 10 was getting out," and we all had to run to put him back and tuck him up again.

These various interruptions made our decorations a very slow process, but eventually the ward looked very nice, and I think the patients had a very happy Christmas; even the two poor cut-throat men seemed quite pleased and interested in their presents, though they were neither of them able to enjoy the privilege of a smoke, which all the other men (including the policemen) so much enjoyed on Christmas Day.

One man who came in with a damaged knee told me that he was a rival "strong man" to Sandow; and, as he was verging on delirium tremens for some days, we felt a little anxious until he calmed down; but he proved to be quite a nice patient.